Dupuytren contracture is a problem in which localized shortening or contracture of hand tissue occurs due to localized formation of scar tissue within the fascial layer of the palm, just beneath the skin surface. The fascia is a thin layer of tissue that normally covers the tendons that flex the fingers. As Dupuytren contracture progresses over time, this advancing scar formation causes a larger and thicker contracture of hand fascia resulting in a shortening and reduced mobility of the fingers, and eventually contractures of fingers or lumps on palms. A characteristic puckered and dimpled appearance of the palm in a small localized area eventually occurs.

Cause of Dupuytren contracture of hand

While the exact cause of Dupuytren contracture remains unknown, it has long been known to occur more frequently in those patients who also have diabetes mellitus, alcoholism, and various types of epilepsy seizure disorders.

Additionally, there is also a genetic component to Dupuytren’s contracture, meaning the tendency for contracture of hand tissue can be inherited. In technical terms, the inherited form of Dupuytren’s contracture is transferred within a family as an autosomal dominant trait with incomplete penetrance and partial sex-limitation. As such, the Dupuytren contracture gene is not on an X or Y chromosome, but on one of the other 44 chromosomes. Consequently, a single version of the gene is dominant although not every family member who has the gene expresses the tendency to develop the contracture of hand tissue. This gene expression is partially limited to males, who are at least eight to nine times more likely to develop Dupuytren contracture than females. Additionally, Dupuytren contracture has a statistical genetic preference for those of northern European and Scandinavian descent, and less so those of a dark skin dominance.

Symptoms of Dupuytren contracture

Dupuytren contracture may initially cause only a minor and painless nodule or lump on the palm of the hand close to the base of one or more fingers. As this hand contracture advances over time it can lead to the involved finger being more and more flexed, with inability to fully extend the affected finger(s). The result is a progressive reduction of the normal range of finger movement, progressive inability to straighten the finger, grasp or engage in a wide range of activities of daily living.

Dupuytren contracture most frequently affects the ring (fourth) finger, next the middle (third) finger, next the little (fifth) finger, although it can affect any and all fingers. Dupuytren contracture can also affect one or both hands. Often the degree and pattern of the contracture of hand tissue will be different when two hands are affected.

Dupuytren contracture is sometimes mildly painful when it first starts. Seldom is this condition associated with much, if any, pain in the later stages unless the affected fingers are accidentally hyperextended with sudden force.

Treatment of Dupuytren contracture

Dupuytren contracture treatment depends on the phase of the problem, the severity and the basic health condition of the patient.

The earlier natural Dupuytren treatment options are started, the more likely that conservative Alternative Medicine treatment will be helpful. Since 2002 the Dupuytren Contracture Institute has developed a treatment protocol to increase the ability of the body to reduce and remove the offending fascia scar that causes the contracture of hand posture. If someone attempts self-help treatment using these methods while the contracture is not very severe, or if the fundamental health of the individual is good, results are usually better.

If after attempting an aggressive and well-rounded course of conservative treatment using the concepts of the Dupuytren Contracture Institute for a reasonable amount of time and no improvement is noted, then more invasive drug injection and surgical options can always be considered.